Table 1.
Characteristics and outcomes of patients with VSD according to closure status
| All patients (n = 138) | Surgical closure (n = 93) | No surgical closure (n = 45) | P-value | |
|---|---|---|---|---|
| Baseline characteristics | ||||
| Age (years) | 70 (± 10) | 68 (10) | 74 (9) | 0.002 |
| Female gender | 63 (46%) | 43 (46%) | 20 (44%) | 0.843 |
| Chronic kidney disease | 4 (3%) | 3 (3%) | 1 (2%) | 1 |
| Known coronary artery disease | 14 (10%) | 7 (7%) | 7 (15%) | 0.143 |
| COPD | 11 (8%) | 7 (7%) | 4 (9%) | 0.835 |
| Baseline organ failures | ||||
| SOFA score at ICU admission (n = 101) | 7 (3) | 6 (3) | 8 (4) | 0.004 |
| Lactatemia at ICU admission (mmol/L) (n = 74) | 4.9 [3.4; 6.4] | 3.9 [2.5; 5.3] | 6.5 [3.8; 9.1] | 0.083 |
| Creatinine at ICU admission (µmol/l) (n = 96) | 131 [83; 179] | 108 [72; 144] | 164 [97; 231] | < 0.001 |
| Norepinephrine at ICU admission | 106 (82%) | 77 (83%) | 29 (64%) | 0.017 |
| Dobutamine at ICU admission | 105 (81%) | 73 (78%) | 32 (71%) | 0.340 |
| Epinephrine at ICU admission | 28 (28%) | 21 (32%) | 7 (25%) | 0.336 |
| Myocardial infarction | ||||
| Delay between first symptoms and admission (d) | 2 [1; 5] | 2 [1; 5] | 2 [1; 4] | 0.563 |
| Myocardial infarction site: | ||||
| - Anterior | 61 (44%) | 42 (45%) | 19 (42%) | 0.744 |
| - Inferior | 77 (56%) | 51 (55%) | 26 (58%) | |
| Culprit lesion: | ||||
| - Left anterior descending artery | 74 (54%) | 51 (55%) | 23 (51%) | 0.068 |
| - Left circumflex artery | 2 (1.5%) | 0 | 2 (4%) | |
| - Right coronary artery | 52 (38%) | 38 (41%) | 14 (31%) | |
| Number of affected coronary vessels: | ||||
| - 1 | 71 (51%) | 56 (60%) | 15 (33%) | 0.014 |
| - 2 | 26 (19%) | 17 (18%) | 9 (20%) | |
| - 3 | 31 (22%) | 16 (17%) | 15 (33%) | |
| PCI of culprit lesion | 64 (46%) | 39 (42%) | 25 (55%) | 0.101 |
| Echocardiographic parameters | ||||
| LVEF (%) | 42 (13) | 43 (14) | 42 (13) | 0.638 |
| Right ventricle dysfunction | 68 (49%) | 47 (50%) | 21 (47%) | 0.761 |
| VSD diameter (mm, n = 125) | 18 [10; 26] | 20 [12; 28] | 19 [9; 29] | 0.626 |
| VSD location: | ||||
| - Anterior/apical | 74 (54%) | 52 (56%) | 22 (50%) | 0.825 |
| - Posterior/inferior | 63 (46%) | 41 (44%) | 22 (50%) | |
| Pericardial effusion | 17 (12%) | 10 (11%) | 7 (15%) | 0.647 |
| Mechanical circulatory support | ||||
| MCS use | 116 (84%) | 82 (88%) | 34 (75%) | 0.058 |
| IABP | 99 (72%) | 71 (76%) | 28 (62%) | 0.084 |
| Veno-arterial ECMO | 43 (31%) | 29 (31%) | 14 (31%) | 1 |
| Others | 7 (5%) | 4 (4%) | 3 (7%) | 0.682 |
| Percutaneous VSD surgical closure | 14 (10%) | 12 (13%) | 2 (4%) | 0.145 |
| Outcomes | ||||
| MCS duration (d) | 5 [3; 9] | 7 [4; 10] | 3 [2; 6] | 0.010 |
| Norepinephrine duration (d, n = 57) | 3 [1; 6] | 3 [2; 8] | 3 [2; 6] | 0.094 |
| Dobutamine duration (d, n = 154) | 5 [2; 10] | 7 [3; 12] | 3 [1; 5] | 0.007 |
| Ventilation duration (d, n = 98) | 5 [1; 13] | 6 [1; 15] | 3 [1; 10] | 0.066 |
| RRT use during ICU stay | 43 (31%) | 29 (31%) | 14 (31%) | 0.993 |
| ICU length of stay (d) | 10 [5; 22] | 15 [7; 30] | 6 [3; 10] | < 0.001 |
| In-ICU mortality | 84 (61%) | 39 (42%) | 45 (100%) | < 0.001 |
Continuous variables are expressed as mean ± standard deviation or median [interquartile range (IQR)]; categorical variables are expressed as n (%). Abbreviations: VSD ventricular septal defect; CABG coronary artery bypass graft; COPD chronic obstructive pulmonary disease; d days; ECMO extra corporeal membrane oxygenation; IABP intra-aortic balloon pump counter pulsation; ICU intensive care unit; LVEF left ventricular ejection fraction; MCS mechanical circulatory support; PCI percutaneous coronary intervention; RRT renal replacement therapy; SOFA sequential organ failure assessment. Bolded results are statistically significant at the P-value < 0.05 level. When not precised, percentages were calculated over the whole cohort (i.e. 138 patients). Chronic kidney disease denoted patients with an estimated glomerual filtration rate below 60 mL/min/1.73m2